JZUS - Journal of Zhejiang University SCIENCE

Journal of Zhejiang University SCIENCE B

Accepted manuscript available online (unedited version)

Perforation of the esophagus: an overlooked cause of chest pain as a complication of esophageal foreign bodies

Author(s): Chengfan QIN, Yunmei YANG, Yuanqiang LU
Affiliation(s): Department of Geriatric and Emergency Medicine, the First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou 310003, China; more
Corresponding email(s): luyuanqiang@zju.edu.cn
Key Words: Chest pain; Esophageal foreign body; Esophageal perforation

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Chengfan QIN, Yunmei YANG, Yuanqiang LU. Perforation of the esophagus: an overlooked cause of chest pain as a complication of esophageal foreign bodies[J]. Journal of Zhejiang University Science B,in press.Frontiers of Information Technology & Electronic Engineering,in press.https://doi.org/10.1631/jzus.B2300026

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author="Chengfan QIN, Yunmei YANG, Yuanqiang LU",
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year="in press",
publisher="Zhejiang University Press & Springer",
doi="https://doi.org/10.1631/jzus.B2300026"
}

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%A Yuanqiang LU
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doi="https://doi.org/10.1631/jzus.B2300026"

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A1 - Yuanqiang LU
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doi="https://doi.org/10.1631/jzus.B2300026"

Abstract
Chinese Summary
Academic Network
Reviewer Comment

Abstract: Chest pain is one of the most common complaints in the emergency department. Diseases of the heart, aorta, lungs, esophagus, stomach, mediastinum, pleura, and abdominal viscera can all cause chest discomfort (Gulati et al., 2021; Jiao et al., 2021; Lu et al., 2022). Clinicians in the emergency department are expected to immediately recognize life-threatening chest pain (Jiao et al., 2021). Delayed diagnosis further increases the risk of complications and mortality (Liu et al., 2021). In this case, we present an elderly Chinese female who had a history of myocardial infarction two years previously, with chest pain eventually found to be caused by ingestion of a duck bone.

食管穿孔：作为食管异物并发症引起胸痛的一个被忽视的原因

秦铖璠^1,2，杨云梅^1,2，陆远强^1,2
¹ 老年医学与急诊医学，浙江大学医学院附属第一医院，中国杭州市，310003
² 浙江省增龄与理化损伤性疾病诊治研究重点实验室，中国杭州市，310003
摘要：胸痛是急诊科常见的主诉，食管异物（esophageal foreign body，EFB）的摄入是导致胸痛的重要原因之一，并可能引起一系列危及生命的情况。在本文中我们报道了一例病例：一名67岁的中国女性因胸痛入住当地医院，因患者两年前曾有心肌梗死病史，当地医院以急性冠脉综合征对症治疗，然而患者的症状始终不缓解且出现发热，转至我院后行胸部CT提示食管异物伴食管穿孔。患者紧急接受了内镜下食管异物取出术，取出一根长约3 cm的鸭骨头。考虑到中国有着多元的饮食文化，许多中国人习惯啃食鸡骨、鸭骨和猪骨，这会大大增加成人食管异物摄入的风险。本病例旨在提高急诊医师对于食管异物引发胸痛的意识，并提示了通过及时的内镜下治疗可以大大降低食管溃疡、食管出血、肺部感染等并发症的发生风险，进而改善患者预后，缩短住院时间。

关键词组：食管异物；胸痛；食管穿孔

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Reference

[1]BirkM, BauerfeindP, DeprezPH, et al., 2016. Removal of foreign bodies in the upper gastrointestinal tract in adults: European Society of Gastrointestinal Endoscopy (ESGE) Clinical Guideline. Endoscopy, 48(5):489-496.

[2]GulatiM, LevyPD, MukherjeeD, et al., 2021. 2021 AHA/ACC/ASE/CHEST/SAEM/SCCT/SCMR Guideline for

[3]the Evaluation and Diagnosis of Chest Pain: a report of the American College of Cardiology/American Heart Association Joint Committee on Clinical Practice Guidelines. Circulation, 144(22):e368-e454.

[4]JiaoY, WangJH, YangX, et al., 2021. Evaluation of the prognostic ability of serum uric acid for elderly acute coronary syndrome patients with diabetes mellitus: a prospective cohort study. J Zhejiang Univ-Sci B (Biomed & Biotechnol), 22(10):856-865.

[5]LiuCY, ChenSX, ZhangHF, et al., 2021. Bioinformatic analysis for potential biological processes and key targets of heart failure-related stroke. J Zhejiang Univ-Sci B (Biomed & Biotechnol), 22(9):718-732.

[6]LuJQ, LiuJY, LiA, 2022. Roles of neutrophil reactive oxygen species (ROS) generation in organ function impairment in sepsis. J Zhejiang Univ-Sci B (Biomed & Biotechnol), 23(6):437-450.

[7]RuanWS, LuYQ, 2020. The life-saving emergency thoracic endovascular aorta repair management on suspected aortoesophageal foreign body injury. World J Emerg Med, 11(3):152-156.

[8]RuanWS, LiYN, FengMX, et al., 2020. Retrospective observational analysis of esophageal foreign bodies: a novel characterization based on shape. Sci Rep, 10:4273.

[9]ZhaoXH, LuYQ, 2014. Multiple embolisms resulted from a huge fishbone piercing the left atrium. Intensive Care Med, 40(4):621-622.

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食管穿孔：作为食管异物并发症引起胸痛的一个被忽视的原因

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